Elderly Subset Analysis of Randomized Phase?III Study Comparing Pemetrexed Plus Carboplatin with Docetaxel Plus Carboplatin as First-Line Treatment for Patients with Locally Advanced or Metastatic Non-Small Cell Lung Cancer

摘要

Background Many physicians consider platinum-doublet chemotherapy inappropriate for elderly patients, regardless of their medical fitness. Objective This was a retrospective subgroup analysis of data from a multicenter, randomized, phase?III clinical trial evaluating pemetrexed?+?carboplatin versus docetaxel?+?carboplatin in elderly chemo-naive patients with advanced, nonsquamous non-small cell lung cancer (NSCLC). Methods Data from elderly patients (aged ≥65?years and ≥70?years) were evaluated using the same statistical methods as those used in patients aged Results The ≥65- and ≥70-year age groups had 68 and 37 patients, respectively. Among patients aged ≥65?years, the adjusted hazard ratio (HR) for survival without grade?3–4 toxicity (HR?0.40, 95?% confidence interval [CI] 0.23–0.70) favored pemetrexed?+?carboplatin; this was similar to the HRs in patients aged ≥70?years (HR?0.43, 95?% CI 0.20–0.92), patients aged Conclusion The benefits of pemetrexed?+?carboplatin were maintained, and toxicity was manageable in both elderly subgroups. The favorable risk–benefit profile of pemetrexed?+?carboplatin makes it an appropriate first-line treatment option for elderly patients with advanced nonsquamous NSCLC.